The use of continuous, closed suture loops has been incorporated in soft tissue surgeries in recent years, particularly since the proliferation of the use of knotless anchors. The decrease in the number of knots needed in a surgery is important as there is always a chance a knot may loosen or come undone, thereby compromising the repair. Additionally, the knot itself can create a weakened area which may result in a higher incidence of suture breakage.
Currently, a challenge in the suture art is developing a continuous suture loop that can be affixed to a suture anchor, tissue, or the like in an efficient manner. For example, issues tend to arise when using continuous suture loops when an operator (e.g., a surgeon or the like) attempts to obtain a desired tension on the soft tissue. This is particularly difficult in a repair of a torn anterior cruciate ligament (ACL) in a knee of a patient. In such a repair, the operator must properly tension the replacement ACL graft to ensure a successful result. When a standard continuous suture loop is used to fix the graft in a bone tunnel in the femur (via a suture button, as is known in the art), the operator can only control the tension by tensioning the graft, and affixing the graft at the desired tension, in a bone tunnel in the tibia. This is often times difficult to achieve and thus, has a tendency to reduce the effectiveness of such repairs. Additionally, when a standard continuous suture loop is utilized, the operator must carefully select the appropriate loop length and tunnel depth based on the size of the graft and the patient's anatomy, which may increase the risk of error or increase procedure length. Furthermore, current continuous suture loops can be difficult to secure to a suture anchor, suture button, or the like.
Presently, certain adjustable suture loops may be formed from multiple strands of suture and utilize a variety of external structures, such as sleeves, to form the adjustable portion structure. Other adjustable portion devices may be formed from a single strand of suture, which is typically folded along its length, sometimes multiple times, resulting in multiple free strands and a maze of filament running in multiple directions. Further, these adjustable portions may also utilize external structures to hold its configuration in place. The cacophony of filament produced by these devices in conjunction with external structures may increase the likelihood of snagging and increase the number of components, thereby increasing the probability of failure of one of these components. Further, the surgeon must divert his or her focus in order to ensure the adjustable suture loop does not become entangled with itself or other structures, oftentimes with limited success.
Thus, there is a need for a knotless, continuous, adjustable, closed suture structure, such as a loop, that is reliable and easy to use.